Pr CAMUZARD Olivier

Glomus tumors of the upper limb: Single-center retrospective study of clinical and functional outcomes

K Hufschmidt, R Foissac, O Camuzard, N Cardot-Leccia, B Chignon-Sicard, T Balaguer

https://pubmed.ncbi.nlm.nih.gov/28549884/

Abstract

Glomus tumors are rare and benign hamartomas, arising from neuro-myo-arterial proliferation and deriving from mesenchymal origin. As they have a long-term impact on the individual’s quality of life, the primary complaint is unbearable pain. The aim of this study was to assess the clinical and functional outcomes of their surgical treatment, and to review their clinical, radiological and therapeutic features. We performed a retrospective study over a 16-year period including 31 patients with an upper limb glomus tumor. Epidemiologic, diagnostic, therapeutic and follow-up data were collected and a functional outcome questionnaire was filled out postoperatively. Thirty-one patients underwent surgery with safe macroscopic resection margins. The glomus tumor was located on the fingers in 77.4% of cases, with predominance in the ring finger (41.9% of the cases). Patient age at surgery ranged from 22 to 80 years old (mean: 54.6) with a sex ratio of 0.48. Upon clinical suspicion, magnetic resonance imaging and ultrasound were done in most cases. Immediate pain relief was obtained in 18 cases. Only one patient underwent a second surgery for incomplete removal and persistent pain. The QuickDASH questionnaire was completed by 24 patients, resulting in a mean score of 1.61, with a mean follow-up time of 88.8 months (range: 3-171 months). Seven patients were lost to follow-up. These subcutaneous, mostly subungual, nodules, with predominance on the ring finger, have a disproportionate negative impact despite their small size. The long-term outcomes after microscope-assisted surgery indicate obvious improvement in the quality of life and the patient’s satisfaction, with a very low rate of recurrence.

Keywords: Chirurgie de la main; Glomus tumors; Hand surgery; Membre supérieur; Periungual; Périunguéal; QuickDASH; Tumeurs glomiques; Upper limb.

Copyright © 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Homeotic and Embryonic Gene Expression in Breast Adipose Tissue and in Adipose Tissues Used as Donor Sites in Plastic Surgery

Rémi Foissac, Phi Villageois, Bérengère Chignon-Sicard, Charalambos Georgiou, Olivier Camuzard, Christian Dani

https://pubmed.ncbi.nlm.nih.gov/28234838/

Abstract

Background: Autologous fat grafting has become an essential procedure in breast reconstructive surgery. However, molecular knowledge of different adipose donor sites remains inadequate. Tissue regeneration studies have shown that it is essential to match the Hox code of transplanted cells and host tissues to achieve correct repair. This study aims to provide a better molecular understanding of adipose tissue.

Methods: Over the course of 1 year, the authors prospectively included 15 patients and studied seven adipose areas: chin, breast, arm, abdomen, thigh, hip, and knee. The first step consisted of the surgical harvesting of adipose tissue. RNA was then extracted and converted into cDNA to study gene expression levels of 10 targeted genes by real-time polymerase chain reaction.

Results: Forty samples from Caucasian women with a mean age of 48 years were studied. The expression of PAX3, a marker of neuroectodermal origin, was significantly higher in the breast, with a decreasing gradient from the upper to lower areas of the body. An inverse gradient was found for the expression of HOXC10. This expression profile was statistically significant for the areas of the thigh and knee compared with the breast (p < 0.0083).

Conclusions: Breast fat may have a specific embryologic origin compared with the knee and thigh. The reinjection of adipocytes from the infraumbilical area leads to the transfer of cells highly expressing HOXC10. This study raises questions about the safety of this procedure, and future studies will be required to examine molecular modifications of adipose cells transferred to a heterotopic location.

Clinical question/level of evidence: Therapeutic, V.

Primary radical ablative surgery and fibula free-flap reconstruction for T4 oral cavity squamous cell carcinoma with mandibular invasion: oncologic and functional results and their predictive factors

Olivier Camuzard, Olivier Dassonville, Marc Ettaiche, Emmanuel Chamorey, Gilles Poissonnet, Riadh Berguiga, Axel Leysalle, Karen Benezery, Frédéric Peyrade, Esma Saada, Raphael Hechema, Anne Sudaka, Juliette Haudebourg, François Demard, José Santini, Alexandre Bozec

https://pubmed.ncbi.nlm.nih.gov/27438536/

Abstract

The aims of this study were to evaluate clinical outcomes and to determine their predictive factors in patients with oral cavity squamous cell carcinoma (OCSCC) invading the mandibular bone (T4) who underwent primary radical surgery and fibula free-flap reconstruction. Between 2001 and 2013, all patients who underwent primary surgery and mandibular fibula free-flap reconstruction for OCSCC were enrolled in this retrospective study. Predictive factors of oncologic and functional outcomes were assessed in univariate and multivariate analysis. 77 patients (55 men and 22 women, mean age 62 ± 10.6 years) were enrolled in this study. Free-flap failure and local and general complication rates were 9, 31, and 22 %, respectively. In multivariate analysis, ASA score (p = 0.002), pathologic N-stage (p = 0.01), and close surgical margins (p = 0.03) were independent predictors of overall survival. Six months after therapy, oral diet, speech intelligibility, and mouth opening functions were normal or slightly impaired in, respectively, 79, 88, and 83 % of patients. 6.5 % of patients remaining dependent on enteral nutrition 6 months after therapy. With acceptable postoperative outcomes and satisfactory oncologic and functional results, segmental mandibulectomy with fibula free-flap reconstruction should be considered the gold standard primary treatment for patients with OCSCC invading mandible bone. Oncologic outcomes are dependent on three main factors: ASA score, pathologic N-stage, and surgical margin status.

Keywords: Fibula; Free-flap; Head neck cancer; Mandible; Oral cavity; Reconstruction.

Intravenous Hyaluronidase with Urokinase as Treatment for Arterial Hyaluronic Acid Embolism

Rémi Foissac, Philippe Kestemont, Olivier Camuzard

https://pubmed.ncbi.nlm.nih.gov/27140038/

Sex-specific autophagy modulation in osteoblastic lineage: a critical function to counteract bone loss in female

Olivier Camuzard, Sabine Santucci-Darmanin, Véronique Breuil, Chantal Cros, Tatiana Gritsaenko, Sophie Pagnotta, Laurence Cailleteau 5, Séverine Battaglia, Patricia Panaïa-Ferrari, Dominique Heymann, Georges F Carle, Valérie Pierrefite-Carle

https://pubmed.ncbi.nlm.nih.gov/27634908/

Abstract

Age-related bone loss is associated with an increased oxidative stress which is worsened by estrogen fall during menauposis. This observation has drawn attention to autophagy, a major cellular catabolic process, able to alleviate oxidative stress in osteoblasts (OB) and osteocytes (OST), two key bone cell types. Moreover, an autophagy decline can be associated with aging, suggesting that an age-related autophagy deficiency in OB and/or OST could contribute to skeletal aging and osteoporosis onset.In the present work, autophagy activity was analyzed in OST and OB in male and female mice according to their age and hormonal status. In OST, autophagy decreases with aging in both sexes. In OB, although a 95% decrease in autophagy is observed in OB derived from old females, this activity remains unchanged in males. In addition, while ovariectomy has no effect on OB autophagy levels, orchidectomy appears to stimulate this process. An inverse correlation between autophagy and the oxidative stress level was observed in OB derived from males or females. Finally, using OB-specific autophagy-deficient mice, we showed that autophagy deficiency aggravates the bone loss associated with aging and estrogen deprivation.Taken together, our data indicate that autophagic modulation in bone cells differs according to sex and cell type. The lowering of autophagy in female OB, which is associated with an increased oxidative stress, could play a role in osteoporosis pathophysiology and suggests that autophagy could be a new therapeutic target for osteoporosis in women.

Keywords: Gerotarget; aging; autophagy; osteoblast; osteocyte; osteoporosis.

The Vascularized Lateral Antebrachial Cutaneous Nerve Graft Based on a Radial Artery Perforator for Nerve Defect Reconstruction: An Anatomical Study

Olivier Camuzard, Rémi Foissac, Patrick Baqué, Nicolas Bronsard, Charalambos Georgiou

https://pubmed.ncbi.nlm.nih.gov/26397801/

AJCO: Association of Young Surgical Oncologists

Thomas Sorin, Olivier Camuzard, Adnan El-Bakri, Thomas Sagardoy, Antoine Legras

https://pubmed.ncbi.nlm.nih.gov/26455928/

A rare cause of ulnar nerve entrapment at the elbow area illustrated by six cases: The anconeus epitrochlearis muscle

J Fernandez, O Camuzard, M-O Gauci, M Winter

https://pubmed.ncbi.nlm.nih.gov/26545312/

Abstract

Ulnar nerve entrapment is the second most common compressive neuropathy after carpal tunnel syndrome. The accessory anconeus epitrochlearis muscle – present in 4% to 34% of the general population – is a known, but rare cause of ulnar nerve entrapment at the elbow. The aim of this article was to expand our knowledge about this condition based on six cases that we encountered at our hospital between 2011 and 2015. Every patient had a typical clinical presentation: hypoesthesia or sensory deficit in the fourth and fifth fingers; potential intrinsics atrophy of the fourth intermetacarpal space; loss of strength and difficulty with fifth finger abduction. Although it can be useful to have the patient undergo ultrasonography or MRI to aid in the diagnosis, only electromyography (EMG) was performed in our patients. EMG revealed clear compression in the ulnar groove, with conduction block and a large drop in nerve conduction velocity. Treatment typically consists of conservative treatment first (splint, analgesics). Surgical treatment should be considered when conservative treatment has failed or the patient presents severe neurological deficits. In all of our patients, the ulnar nerve was surgically released but not transposed. Five of the six patients had completely recovered after 0.5 to 4years follow-up. Ulnar nerve entrapment at the elbow by the anconeus epitrochlearis muscle is not common, but it must not be ignored. Only ultrasonography, MRI or, preferably, surgical exploration can establish the diagnosis. EMG findings such as reduced motor nerve conduction velocity in a short segment of the ulnar nerve provides evidence of anconeus epitrochlearis-induced neuropathy.

Keywords: Anconeus epitrochlearis muscle; Compression du nerf ulnaire; Compressive neuropathy; Muscle anconeus epitrochlearis; Neurolyse; Neurolysis; Neuropathie compressive; Ulnar nerve compression.

Copyright © 2015 SFCM. Published by Elsevier Masson SAS. All rights reserved.

A strange form of dysphonia… . Laryngeal paraganglioma

Etienne Berta, Olivier Camuzard, Gilles Poissonnet

https://pubmed.ncbi.nlm.nih.gov/26123571/

Contribution of breast skin elastometry measurement in breast augmentation surgery: A pilot study evaluating the correlation between skin elasticity and nipple-to-inframammary fold distance

Rémi Foissac, Olivier Camuzard, Charalambos Georgiou, Pauline Foty, Thierry Balaguer, Bérengère Chignon-Sicard, Dominique Casanova

https://pubmed.ncbi.nlm.nih.gov/26044089/

Axillary hyperhidrosis, botulinium A toxin treatment: Review

C Clerico 1, J Fernandez 2, O Camuzard 2, B Chignon-Sicard 2, T Ihrai 2

https://pubmed.ncbi.nlm.nih.gov/25555435/

Abstract

Injection of type A botulinum toxin in the armpits is a temporary treatment for axillary hyperhidrosis. This technique described in 1996 by Bushara et al., is known to be efficient and safe. The purpose of this article was to review the data concerning the treatment of axillary hyperhidrosis with botulinum toxin type A, and discuss the other treatment modalities for this socially disabling entity.

Keywords: Axillary hyperhidrosis; Botulinium toxin; Hyperhidrose; Hyperhidrosis; Injections; Région axillaire; Toxine botulique.

Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Breast lesions of a metastatic melanoma on a radiotherapy territory: Treatment by vemurafenib and carcinologic surgery

J Fernandez 1, H Montaudié 2, A Courdi 3, C Georgiou 4, O Camuzard 4, B Chignon-Sicard 4

https://pubmed.ncbi.nlm.nih.gov/25446470/

Abstract

Introduction: This article describes the unique case of a female patient who presented distant melanoma metastasis on the breast while having irradiation therapy for breast cancer. This happened eight months after the initial treatment for a melanoma of the back (under the right scapula). Furthermore, this case report demonstrates the efficiency of Vemurafenib® as a treatment for late stage melanomas.

Case report: The patient was a 47-year-old female that had a superficial spreading melanoma under the right scapula (Breslow 1.02mm) that was treated with 2cm skin excision and sentinel lymph node sampling that was negative. The melanoma was positive for the BRAF600E mutation. One month after this incident, the patient developed breast cancer that was treated with conservative surgery and radiotherapy. Three months after the end of the irradiation treatment, she developed multiple melanoma metastasis on the skin of the breast. Our multidisciplinary team decided to initiate a treatment with vemurafenib. The patient showed an excellent response, so the surgical team completed the treatment with a radical mastectomy and immediate reconstruction with a pedicled latissimus dorsi flap. The histologic report of the mastectomy specimen showed no sign of melanocytic proliferation, that demonstrates the efficacy of vemurafenib. The patient showed no relapse after two years of follow-up.

Discussion: The speed of development and location of cutaneous metastases in this case brought us to think about the effects of radiation therapy on the skin. Radiation therapy causes acute complications (radiodermatitis) by cellular and molecular mechanisms. Moreover, depressed immunity is found after irradiation. Association of these mecanisms could explain the appearance of these metastases in irradiation field. The efficiency of vemurafenib found in our case is consistent with what is described in literature, especially with the improvement in median overall survival.

Conclusion: This case demonstrates a unique case of distant melanoma metastasis on the irradiation field of a breast cancer. It also demonstrates the efficacy of vemurafenib as well as the efficacy of a radical complementary surgical treatment in these patients.

Keywords: BRAFV600E; Breast cancer; Cancer du sein; Champ d’irradiation; Cutaneous metastasis; Immunomodulation; Irradiation territory; Melanoma; Mélanome; Métastases cutanées; Radiotherapie; Radiothérapie; Survie; Survival; Vemurafenib; Vémurafénib.

Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Treatment of Dupuytren’s contracture by collagenase injection

R Foissac, O Camuzard, P Dumas, C Dumontier, B Chignon-Sicard

https://pubmed.ncbi.nlm.nih.gov/23856551/

Abstract

Dupuytren’s disease is a disorder of the palmar aponeurosis responsible for apparition of pathological collagen cords that will gradually lead to a digital retraction. These cords cause functional disability to the hand with a real handicap for the patient. No curative treatment exists currently in this disease. Injections of collagenase from Clostridium histolyticum cause lysis of the collagen present in the cords and cause an interruption of the palmar cord. It is a new treatment in the management of Dupuytren’s disease. The use of collagenase injection in the treatment of palmar form of Dupuytren’s disease gives good results in the short and medium terms. It is a simple, minimally invasive treatment, several studies have proven its effectiveness and it approximates percutaneous needle fasciotomy in its easy use and its indications. Patients should be well informed about local reactions and transient pain with the injection of C. histolyticum collagenase. Diffusion of this technique is still limited by: the assessment of its cost compared to that of other methods of treatment and particularly the needle fasciotomy, and the evaluation of results over the long-term.

Keywords: Brides de collagène; Clostridium histolyticum collagenase; Collagen cords; Collagénase de Clostridium histolyticum; Digital retraction; Dupuytren’s disease; Maladie de Dupuytren; Rétraction digitale.

Copyright © 2013 Elsevier Masson SAS. All rights reserved.